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Schizophrenia:  Severe emotional disorder,
usually of psychotic proportions, characterized by withdrawal from reality,
delusion, hallucinations, ambivalence, inappropriate affect, and withdrawn,
bizarre or regressive behavior.

Schizophrenic disorders:  This group of disorders
is marked by withdrawal into self and failure to distinguish between reality
and fantasy.  Studies shows an estimated 2 million Americans may suffer
from this disease.  There is four types of schizophrenia, the different
types share these essential features:  presence of psychotic features
during the acute phase: deterioration from a previous level of functioning,
the onset before age 45, and the presence of symptoms for at least 6 months
with deterioration in occupational functioning, social relations, or self
care. The four type of schizophrenia are:  catatonic, paranoid,
disorganized, and residual.

Schizophrenic disorders produce varying degrees of impairment; 1) the
prodromal phase:  is insidious, occurring about 1 year before
the patient’s first hospitalization.  During this period, the patient
may display signs of a loss of will, inappropriate affect, and impaired
job performance.  2) the active phase:  patient
show signs of psychotic symptoms such as hallucinations and delusions.
This phase marks full development of the disorder.  3) the residual
phase:  resembles the prodromal phase, but more severe. Some
people who suffers from schizophrenic disorder experience repeated, acute
exacerbation of the active phase. Some as many as one third of schizophrenic
patients have just one psychotic episode and no more. Prognosis worsens
with each acute episode.  Some schizophrenic patients have no disability
between periods of exacerbation.

The cause of schizophrenia ar unknown.  There are various theories,
both biological and psychological have been proposed. Expects point to
genetic pre-disposition, hyperdopaminergic conditions, and disturbed family
and interpersonal patterns, But experts has different opinion on this matter.
A recent report that a gene for schizophrenia exists on chromosome 5 hasn’t
yet been confirmed.

Symptoms:

Catatonic schizophrenia: 

Inability to take care of personal needs

Diminished sensitivity to painful stimuli

Negative attitude

Rigidity

May experience rapid swings between excitement and stupor

May experience extreme psychomotor agitation 

Excessive, senseless, and or incoherent shouting or talking.

Often there is an increased potential for destructive, violent behavior.

Paranoid schizophrenia: 

Feeling of persecutory (  of, related to, or being/feeling of persecution: 
paranoid)

Having a grandiose delusional thought content and auditory hallucinations.

May act on delusional thoughts,  inability to function

May exhibit an artificial or elevated mannerism towards others

Unfocused anxiety, anger, argumentativeness, and violence.

Disorganized schizophrenia:

Incoherence

Regressive, silly, flat, incongruous ( not suitable, inappropriate,
not corresponding or conforming ), chaotic speech

Fragmented hallucinations and delusions that are not systematized into
a coherent theme.

May exhibit unpredictable laughter and or grimaces

may have hypochondriacal complaints

Extreme social withdrawal

Regressive behavior

Residual schizophrenia:

Has a previous history of at least one episode of schizophrenia with
prominent psychotic symptoms and continues to suffer from two or more characteristic
symptoms such as:  inappropriate affect, social withdrawal, eccentric
behavior, illogical thinking.

Residual schizophrenia, the patient does not exhibit prominent psychotic
symptoms.

Treatment:

Goal: to control this illness and to equipped the patient with skills
they need to live and an environment that offers opportunity for meaningful
interpersonal relationships.

Patient needs to be under the care of one who is a professional who
specialize in this disorder.

Neuroleptic medication. Drug treatment should be continuous because
schizophrenic patients may relapse when medication is discontinued. * With
all medication, use as prescribe by your doctor.  Call your doctor
if you experience adverse reaction to medication.  * Make sure you
let your doctor know if you start or stop any medication.

Doctors disagree about the effectiveness of psychotherapy in schizophrenics. 
Electroconvulsive therapy ( ECT ) is sometimes used to treat acute schizophrenia
and may be helpful when neuroleptic therapy cannot be used.

Sciatic:  pertaining to the ischium

Sciatica is a form of neuritis ( inflammation of a nerve ) characterized
by severe pain along the sciatic nerve and its branches.  The pain
radiates into one or both buttocks and descends to the back of the leg
or legs, it results from the compression of the sciatic nerve at the base
of the spine.  There are many causes of this disorder, but probably
the most common are rupture of a disk between the lower lumbar vertebrae
and arthritis of the lower part of the spinal column. It can be cause by
poor posture and or muscle strain.

Symptoms:

Pain radiating into one or both buttocks, down the back of the thigh
and down the leg and even foot.

Pain may be a burning feeling

Pain can be dull or sharp

Numbness and weakness

May be aggravated by lilting and or strenuous activity

Usually affects one side of the body. 

An intermittent or continuous, shooting and or burning pain.

Your doctor may do a CT scan, MRI and or X-ray

Treatment:

Physical therapy may be recommended

Your doctor may prescribe anti-inflammatory medication called NSAID’s,
such as Naprosyn. or  Motrin,  There are many others!

Your doctor may prescribe muscle relaxants, and or narcotics

Your doctor may prescribe corticosteroids medication.

To help ease the pain, try sleeping with a pillow under or between your
knees. Avoid sleeping on your stomach, sleep on your back and or side with
your knees bent. A firm mattress is recommended.

If pain persists for more than 72 hours with no relief, accompanied
by leg and or foot weakness, * Call your doctor promptly.

Scoliosis:  a lateral curvature of the vertebral
column., scoliosis may occur in the thoracic, lumbar, or thoracolumbar
spinal segment.  The curve may be convex to the right ( more common
in lumbar curves ) or to the left ( more common lumbar curves)  Rotation
of the vertebral column around its axis occurs and may cause rib cage deformity.
There are two different types of scoliosis; functional  (postural
) ,and   structural .  They are both associated with kyphosis
( humpback ) and
lordosis

( swayback ). Scoliosis usually affects adolescent girls. Most school
now check adolescents for scoliosis, check with your school district if
your interested.

Functional Scoliosis:  it is a results from  poor
posture or a discrepancy in leg lengths. 

Structural Scoliosis:  it involves deformity of the vertebral
bodies.  It may be congenital ( present at and existing from
the time of birth ) such as wedge vertebrae, fused ribs or vertebrae, or
hemivertebrae.  Paralytic ( affected with paralysis ) such
as polio, cerebral palsy, or muscular dystrophy, or idiopathic (
occurring without known cause ), the most common form, may be transmitted
as an autosomal dominant ( a non  – sex- determining chromosome )
or multifactorial trait, it appears in a previously straight spine during
the growing years.

Symptoms:

Curving of the spine ( usually in the thoracic segment ), with convexity
to the right  (having a rounded, somewhat elevated surface ), and
compensatory curves ( S curves ) in the cervical segment above and the
lumbar segment below, both with convexity to the left.

Backache

Fatigue

Dyspnea ( difficulty breathing )

Unequal shoulder heights, elbow levels, and heights of the iliac crests.

Your doctor may want to take an X-ray of your spine

Treatment:

The most effective treatment should begin very early, when spinal deformity
is still subtle.

Your doctor will  determine what course of therapy and or treatment
depending on the severity of the deformity.

A brace may have to worn (Milwaukee brace )

Surgery may be needed

Close observation and exercise

A mild curve ( less than 25 degrees ) can be monitored by X -Rays and
an examination by your doctor every 3 months. Along with exercise program
to strengthen the turso muscles and help prevent curve progression. 
A heel lift may help.

A curve of 25 degrees to 40 degrees requires spinal exercises and a
brace.  Your doctor may prescribe you to undergo transcutaneous electrical
nerve stimulation ( TENS ).  A brace helps to halt progression in
most patients but does not reverse established curvature.

A curve of 40 degrees or more requires surgery ( spinal fusion ), since
a lateral curve progresses at the rate of 1 degree a year even after skeletal
maturity. 

 * Early detection is the Key.  See your doctor if you suspect
and or have any of the symptoms above.

 * If the patient have a brace, keep in mind:  Do not insert
anything or let anything get under the cast and to immediately report cracks
in the cast, and if there is pain, swelling, skin breakdown, and 
numbness see your doctor Promptly.

Cast Syndrome:  a serious complication, this syndrome
may follow spinal surgery and application of a body cast. 

The patient may experience nausea, abdominal pressure, and vague abdominal
pain. Experts believe  the reason for cast syndrome is probably due
to hypertension of the spine. Hypertension of the spine accentuates lumbar
lordosis, with compression of the third portion of the duodenum between
the superior mesenteric artery anteriorly, and the aorta and vertebral
column posteriorly.  High intestinal obstruction produces nausea,
vomiting, and ischemic infraction of the mesentery.

Untreated cast syndrome may be fatal. * Call your doctor immediately,
this syndrome may develop as late as several weeks or months after application
of the cast.

Shingles  also known as Herpes zoster: 
this disorder is an acute unilateral and segmental inflammation of the
dorsal root ganglia caused by infection with the herpes virus varicella
zoster or V -Z, the same virus causes by chicken pox.  Herpes Zoster
produces localized vesicular (relating to small, saclike bodies) skin lesions
confined to a dermatome (the area of skin supplied with afferent nerve
fibers by a single posterior spinal root), and severe neuralgic pain in
peripheral areas innervated ( supply of nerve stimulation sent to a part)
by the nerves arising in the inflamed ganglia ( a group of nerve cell bodies,
located outside the central nervous system).

Cause:  Shingles is caused by reactivation of the herpes virus
V -Z that has lain dormant in the cerebral ganglia (extramedullary ganglia
of the cranial nerves) or the ganglia of posterior nerve roots since a
previous episode of chicken pox.

Symptoms:

Fever

Malaise

Within 2 to 4 days : deep pain, pruritus (itching), and paresthesia
(an abnormal sensation, such as, burning and prickling) or hyperesthesia
(Abnormal increased sensitivity of the skin or organ), more common in the
trunk and occasionally on the arms and legs.

Pain may be continuous or intermittent

Small red  nodular skin lesions then usually erupt on the painful
areas and commonly spread unilaterally around the  thorax or vertically
over the arms or legs.

They quickly become vesicles filled with clear fluid or pus.

After 10 days after they appear, the vesicles usually dry up and form
scabs,

Treatment:

To relieve the itching and neuralgic pain – your doctor may prescribe
calamine lotion or another topical antipruritic 

Aspirin, possibly with codeine or another analgesic

Your doctor may prescribe an application of collodion or tincture of
benzoin to unbroken lesions.

If lesion ruptures an becomes infected an antibiotic may be prescribe

Trigeminal zoster with corneal involvement calls for  instillation
of idoxuridine ointment or another antiviral medication. 

Your doctor may prescribe a combination of treatment for patient with
intractable pain of  postherpetic neuralgia such as ; corticosteroids
to reduce inflammation, of a sedatives or tranquilizers, or an antidepressants
with phenothiazines.

Studies shows that * Zovirax (acyclovir) seems to stop progression
of the skin rash and prevent visceral complications.  * Vidarabine
reportedly speeds healing of lesions, decreases pain and prevents the disease
from spreading and developing complications

 * Call your doctor PROMPTLY if you develop signs of dissemination
(generalized lesions) and CNS infection (headache, fever, stiff neck and
or weakness. 

 * Avoid close contact with individuals who haven’t had chicken
pos until the eruption has resolved. 

Sickle cell anemia:  A congenital hemolytic anemia that occurs primarily but not exclusively in black people,
sickle cell anemia results from a defective hemoglobin molecule ( hemoglobin
S ) that causes RBC’s ( red blood count ) to roughen and become sickle
shape. These cells impair circulation, resulting in chronic ill health,
periodic crises, long term complications, and premature death.

This inherited disease involves an abnormality of hemoglobin, the component
of red blood cells that carries oxygen.  The normal hemoglobin molecule
is of the A type.  In sickle cell disease much of the hemoglobin is
of the type called S type, giving it it’s shape.  Unlike normal, flexible
red cells, the sickled cells are stiff; groups of them may become entangled
in such a way as to obstruct smaller blood vessels.  When obstruction
occurs there is severe joint swelling and pain, more common in the fingers,
and toes, a development often referred to as sickle cell crisis. 
There may also be paralysis and convulsions resulting from cerebral thrombosis.

Symptoms: 

Joint swelling

Pain

Jaundice

Pallor

Chest pains

Aching bones

Ischemic leg ulcer ( especially around the ankles )

Increase susceptibility to infection

Paralysis

Convulsions

Tachycardia ( rapid heart rate )

Cardiomegaly ( enlarge heart )

Systolic and diastolic murmurs

Chronic fatigue

Unexplained dyspnea ( difficulty breathin/labored )

Hepatomegaly ( enlarge liver )

Splenomegaly ( enlarge spleen )

Patient with painful vaso – occlusive crisis may manifest severe abdominal,
thoracic, muscular, or bone pain; possible increased jaundice and dark
urine; low grade fever; and, in long term disease, spleen shrinkage.

Treatment:

Therapy for this anemia is primarily symptomatic and can usually be
done at home.  Hemoglobin level should be check frequently, if hemoglobin
drops suddenly or if the patient condition deteriorates rapidly, he must
be hospitalized for possible transfusion of packed RBCs.  In a sequestration
crisis, treatment may include sedation and administration of analgesics,
blood transfusion, oxygen administration, and administration of large amounts
of oral or I.V. fluids

 * Watch for signs of sickle cell crises:  includes; pale
lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness,
with difficulty awakening; irritability; severe pain temperature over 104
degree C or fever of 100 degree that persist for 2 days.

** CALL YOUR DOCTOR PROMPTLY if you experience the above symptoms.

Sinusitis:  Inflammation of the sinus. 
” I have sinus” is an expression many people use to indicate they have
an infection of the sinuses.  The sinuses are located close to the
nasal cavities, and in one case near the ear.  Infection may easily
travel into these sinuses from the mouth, the nose and the throat along
the mucous membrane lining, and the resulting inflammation is called sinusitis.

The sinuses are opening in the bones around the nose.  There are
four paranasal sinuses, only two , the frontal and maxillary sinuses, can
be assessed. ( In children under age 8, the frontal sinuses are usually
too small to examine.)  The other two, the ethmoidal and sphenoidal
sinuses, are inaccessible for general examination.

Normally, air passes in and out of the sinuses and mucus and fluid drain
from the sinuses into the nose.  Sinusitis usually follows when one
gets a cold and or other respiratory infection, or disease and disorder
such as Cystic Fibrosis.

Sinusitis occurs when there is a undrained collection of pus in one
or more of the sinuses.  Swelling occurs and prevents fluids from
draining out of the sinus.  Fluids trapped in the sinus may then become
infected with bacteria, viruses or fungi.

Disorders such as a deviated septum, obstruction of the nose, allergic
rhinitis are susceptible to sinusitis.  Dental infection such as a
tooth abscess may spread into the sinus and become infected.

Pressure and inflammation results in mild to severe pain.

Long – standing, or chronic, sinus infection may cause changes in the
epithelial cells, resulting in tumor formation.  Some of these growths
have a grape – like appearance and cause obstruction of the air pathway. 
These tumors are called polyps.

Symptoms:

Facial pain – pressure around the eyes, cheeks and or forehead

Facial swelling – common around the eyes

Headache – especially around the eyes and front of head

Nasal drainage

May have pain in the roof of the mouth or teeth

May have fever

May experience chills

Possible sore throat

Possible nosebleed

Bad breath and or foul smell in the nose

Treatment:

Antibiotic therapy

Nasal decongesting

Your doctor may prescribed a mild analgesic for moderate to extreme
pain

If it is due to a deviated septum, repair may be needed which may require
surgery

 * Call your doctor if treatment does not help within 48 hours
after antibiotic therapy

 * Take all of the prescribed antibiotic, stoppage of antibiotic
therapy may result in reinfection and or other complications.

 * Call your doctor promptly if you experience an adverse reaction
to any medication.

Squamous cell carcinoma: The skin cancer is an invasive tumor with
metastatic

potential. It may be caused by overexposure to ultraviolet rays,
X – ray therapy,

chronic skin irritation and inflammation, ingestion of herbicides containing
arsenic, and

exposure to local carcinogens such as tar, and oil. Risk factors
include being white

male, and over age 60. Those who work outdoors and are expose to
the sun, those

who have a pre malignant lesion. Squamous cell carcinoma commonly
develops on

sun damaged areas of the skin.

Symptoms:

A nodule growing on a firm indurated base, there may be some ulceration
at the lesion

site ( if carcinoma develops in normal skin )

A pre malignant, preexisting lesion may be inflamed and indurated.
Metastasis to

regional lymph nodes may cause pain, malaise, fatigue, weakness, and anorexia

Diagnostic test – Excisional biopsy of the lesion confirms the diagnosis

Treatment:

Depending on the lesion, treatment may consist of wide surgical excision
or

electrodesiccation and curettage.

Radiation therapy ( usually used for older or debilitated patients)

Moh’s surgery also may be indicated.

* Regular follow up with your doctor is important

Call your doctor if you have any of the above symptoms.

---

CancerTreatments:

Cancer treatments seek to destroy malignant cells while sparing normal
ones, to

reduce pain, and to induce cure or remission. A single primary treatment
or a

combination of treatments may be used. These treatments can provide
local and

systemic therapy and offer doctors the advantage of attacking cancer cells
with

several mechanisms. They include:

* Chemotherapy – which interrupts malignant cells life cycles, inhibiting
or destroying

their ability to divide

* Radiation – which also inhibits cell division by impairing DNA synthesis
and causing

cell membrane lysis. Radiation can be used as a primary treatment
or as an adjunctive

procedure intended to kill cancer cells that may have survived other treatments.

* Biotherapy ( immunotherapy ), which employs biological response modifiers
that

act on malignant cells by inhibiting division and by enhancing the body’s
immune

responses to such cells.

* Bone marrow transplantation, which is used to replace or replenish the
bone

marrow of patients with leukemia or multiple myeloma

* Surgery, which removes tumors or reduces their size. Surgery enables
other

treatments because there are fewer malignant cells to combat.

* Several new cancer treatments are emerging. surgical treatments
using lasers and

intraoperative radiation can effectively remove tumors or reduce their
size at the time

of initial surgery and staging. Hyperthermia – the use of heat to
destroy cancer cells is

being investigated as a single modality and in combination with radiation
and

chemotherapy.

Stroke also called Cerebrovascular accident or CVA: Is a sudden
impairment of

cerebral circulation in one or more of the blood vessels supplying the
brain. A CVA

interrupts or diminishes oxygen supply and commonly causes serious damage
or

necrosis (death of an individual cell or group of cells) in brain tissues.
The sooner

circulation returns to normal after a CVA, the better the patients chance
for recovery.

There is different types of CVA and are classified according to their course
of

progression. (See * below)

* Transient ischemic attack or TIA , also called ” little stroke”,
it is a result from a
temporary interruption of blood flow. it is considered the least severe.
It is usually a
recurrent episode of neurologic deficit, it may last for just seconds or
hours and clears
within 12 – 24 hours. It is considered to be a warning sign of an
impending thrombotic
cerebrovascular accident (CVA ). Studies shows that TIA’s have
been reported in
50% to 80% of patients who have had a cerebral infarction from such thrombosis..
More common after the age of 50 and men are more prone to have TIA’s.
In TIA, microemboli released from a thrombus probably temporarily interrupt
blood
flow, especially in the small distal branches of the arterial tree in the
brain. Small
spasms in those arterioles may impair blood flow and also precede TIA.
Predisposing
factors are the same as for thrombotic CVAs.
Distinctive characteristics of TIA’s include the transient duration of
neurologic deficits
and complete return of normal function.

Symptoms of TIA’s:

Double vision
Speech deficits ( slurring )
Unilateral blindness
Uncoordinated gait (staggering ) – May fall easily due to weakness of
legs
Unilateral weakness
Numbness
Dizziness

Treatment:

Treatment to prevent a complete CVA –
Aspirin or anticoagulants to minimize the risk of thrombosis.
After or between attacks; preventive treatment includes carotid endarterectomy
or
cerebral microvascular bypass

* Progressive CVA, or stroke – in – evolution ( thrombus – in –
evolution ), begins
with slight neurologic deficit and worsens in a day or two.

* Complete CVA, the patient experiences maximal neurologic deficits
at onset.

Most common cause of CVA is a result from thrombosis. Other causes
include
embolism and hemorrhage. Risk factors increase the likelihood
of CVA, such as
atherosclerosis, hypertension, dysrhythmias, rheumatic heart disease, diabetes
mellitus,
gout, postural hypotension, and cardiac hypertrophy. Other risk factors
include high
serum triglyceride levels, and sedentary life – style ( inactive
habit ), the use of
contraceptives, cigarette smoking, and a family history of CVA.

CVA Symptoms:

Clinical features of CVA vary with the artery affected ( and , Consequently,
the portion
of the brain it supplies ), the severity of damage, and the extent of collateral
circulation
that develops to help the brain compensate for decreased blood supply.
If CVA occurs
in the left hemisphere, it produces symptoms on the right side; if in the
right hemisphere,
symptoms are on the left side. However, a CVA that causes cranial
nerve damage
produces signs of cranial nerve dysfunction on the same side as the hemorrhage.
Usually the symptoms are classified according to the artery affected.
It can also be
classified as premonitory, generalized, and focal.

Middle cerebral artery: This type of CVA may cause aphasia ( loss
of the power of
expression of speech, writing, or signs or of comprehending spoken or written
language)
, dysphasia ( impairment of speech), visual field cuts, and hemiparesis
on the affected
side ( more severe in the face and arm than in the leg ).

Carotid artery: The patient may experience weakness, paralysis, numbness,
sensory
changes, visual disturbances on the affected side, altered level of consciousness,
bruits,
headaches, aphasia, and ptosis ( paralytic drooping of the upper eyelid
).

Vertebrobasilar artery: patients may experience weakness on the affected
side,
numbness around the lips and mouth, visual field cuts, diplopia ( the preception
of two
images of a single object ), poor coordination, dysphagia, slurred speech,
dizziness,
amnesia, and failure of muscular coordination (ataxia).

Anterior cerebral artery: This type of stroke can cause confusion,
weakness and
numbness on the affected side ( especially in the leg ), incontinence,
loss of coordination,
impaired motor and sensory functions, and may have personality changes.

Posterior cerebral arteries: Paralysis usually doesn’t occur.
Patient may experience
visual field cuts, sensory impairment, dyslexia, coma, and cortical blindness.

Diagnostic tests: CT scan shows evidence of thrombotic or hemorrhagic
stroke, tumor,
or hydrocephalus. Brain scan show ischemic areas but may not be positive
for up to 2
weeks after the CVA. Other tests includes; lumbar puncture, ophthalmoscopy,
angiography, EEG, and lab studies.

Treatment:

Medication useful in CVA include: anticonvulsants to treat seizures,
stool softeners, to
avoid straining, which increases ICP ( intracranial – pressure ), corticosteroids,
to
minimize associated cerebral edema, analgesics to relieve headache that
may follow
hemorrhagic CVA. Usually aspirin is contraindicated in hemorrhagic
CVA because it
increases bleeding tendencies, but it may be useful in preventing TIAs.

Surgery to improve cerebral circulation for patients with thrombotic or
embolic CVA
includes; endarterectomy ( removal of atherosclerotic plaques from inner
arterial wall),
or microvascular bypass ( extracranial vessel is surgically anastomosed
to an intracranial vessel ).

Cold Sore Freedom In 3 Days

Syphilis:  This Chronic, infectious venereal disease begins in the mucous membranes and rapidly becomes systemic, spreading to nearby lymph nodes and the bloodstream.  The infecting agent is the spirochete Treponema pallidum.  Syphilis spreads by sexual contact during the primary, secondary and early latent stages of infection.  For those expecting mothers who has this
disorder, it may be spread to the neonate through the placenta.

Syphilis rank the third most prevalent reportable infectious disease in the United States, and more common between the ages of 15 to 39.  If left untreated syphilis leads to crippling or death.  Prognosis is excellent with early treatment. 

Symptoms:

Clinical features vary with the stage of the disease: 

Primary syphilis:  Applies to a period of 3 weeks after contact.  Patients may develop chancres – small fluid filled lesion on the genitalia, fingers, anus, lips, tongue, nipples, tonsils, or eyelids that eventually erode and develop indurated ( becomes abnormally hard), raised edges and clear bases.  Regional lymphadenopathy may also occur (disease of the lymph nodes) 

Secondary syphilis:  Applies to a period from a few days to 8 weeks after the onset of initial chancres.  Patients may exhibit a rash which can be macular (a distinguishable by color, thickening , spot), it can be papular ( a small circumscribed, solid, elevated lesion of the skin), or it could be nodular (resembling nodules), and it can be symmetrical mucocutaneous (pretaing to
mucous membrane and skin) lesions. Macules commonly erupt between rolls of fat on the trunk and, proximally on the arms, palms, soles, face, and scalp. Condylomata lata may develop it drives in warm, moist areas such as the perineum, scrotum, vulva, and between rolls of fat, the lesions may be enlarge and erode, producing highly contagious, pink or grayish white
lesions. 

Watch for signs of general lymphadenopathy; mild constitutional symptoms such as headache, malaise, anorexia, weight loss, nausea, vomiting, and sore throat. Patient may have brittle and pitted nails, possible a low grade fever, and may have hair loss (alopecia). 

Latent syphilis:  Characterized by an absence of symptoms 

Late syphilis:  This stage includes three subtypes;  late benign syphilis, cardiovascular syphilis, and neurosyphilis.  Any or all may be present during this stage. 

*Late benign syphilis:   the typical lesion is a gumma – a chronic, superficial nodule or deep granulomatous (a tumor like mass) lesion that is solitary, asymmetrical, painless, and  abnormally hard (indurated).  Other symptoms may affect the liver, causing epigastric pain, tenderness, enlarged spleen, and anemia; also the patient may develop upper respiratory involvement with potential perforation of the nasal septum or palate.

*Cardiovascular syphilis:  The patient may develop aortitis (inflammation of the aortic), aortic regurgitation, or aortic aneurysm, or the patient may experience no symptoms at all.

* Neurosyphilis:  meningitis and widespread CNS (Central nervous system) damage, symptoms includes, general paresis (slight or incomplete paralysis ), personality changes, and arm and leg weakness.

Treatment: 

Antibiotic therapy, treatment of choice is penicillin I.M. For early syphilis, treatment may consist of a single injection of penicillin G benzathine I.M. Syphilis of more than 1 year’s duration should be treated with penicillin G benzathine I.M. for 3 weeks.

Patient who is allergic to penicillin may be treated successfully with tetracycline or erythromycin – 15 days for early syphilis; and 30 days for late infections; usually by mouth 4 times a day.

 * Important to complete the course of therapy even after symptoms subside. 

 * Have a recheck scheduled appointment with your doctor after 3, 6, 12, and 24 months to detect a possible relapse. 

 * For patients who is treated for latent or late syphilis should receive blood tests at 6 months intervals for 2 years. 

 * Please inform your sex partner of his infection so they can receive treatment, and to prevent the spread of this disease.